It is a particularly good build when used against physical and elemental characters due to the effectiveness of such skills as Whirling Defense coupled with ranger armor, which is highly resistant to elemental damage.

Aggressively built weapon sets might combine 15% extra damage, more energy and a 20% chance for +1 Blood Magic, while defensive sets might include a +10AL staff or focus to mitigate damage. Multiple weapon sets can be held in inventory for various circumstances, including of Enchanting mods to extend enchantment durations, high and low energy sets to modify energy by between -7 and +42 (to hide energy from mesmers), and high and low life sets to modify life by -50 to +60 (to manage sacrifice amounts).

A +45 health 'while enchanted' item is particularly interesting to reduce the health sacrifice of Blood Renewal (cast while not yet enchanted), which then immediately grants the +45 health to offset health just sacrificed. Foci can be obtained that also incorporate '+5AL while enchanted' or '-2 physical damage while enchanted' for additional defense while waiting for the ending heal of Blood Renewal to be given.

The main two skills are currently Vampiric Bite and Vampiric Touch. Previous to the release of Factions, the skills used were Touch of Agony and Vampiric Touch, with the health sacrifice of the former being recovered by the latter. The original Prophecies combination is less energy intensive, but it is also less effective than the now far more common post-Factions variant. Ranged options currently exist in several forms:

Aside from the previously stated touch damage skills, a touch ranger is largely defined by the choice of elite skill. The most common elite is Offering of Blood, which converts some health to energy, and that energy is used to steal back the lost health, and so on. Another classic elite skill in use is Escape, which grants mobility and defense that is second to none. Additional elites that are occasionally used include Life Transfer and Vampiric Spirit.

Touch Rangers use their Expertise skills to protect themselves and their allies. If the elite is aggressive like Offering of Blood, stances such as Whirling Defense, Lightning Reflexes and Dodge can be taken to block attacks and move quickly. If the elite is Escape, additional stances can be dropped to make space for more utility skills. In addition to defensive stances, touch rangers can take Throw Dirt for personal defense as well as to protect allies. Throw Dirt can be followed by Oppressive Gaze to further debilitate foes with Poison and Weakness.

Although touch rangers are infamous for their life-stealing touch, self-healing is also available. Blood Renewal is the most powerful self-heal available and is most effective when it is in constant use and refreshed immediately after it expires. Troll Unguent is another option, in which case Wilderness Survival should be raised to 4 with the aid of a Rune of Minor Wilderness Survival. In either case, the effectiveness of self-healing is greatly enhanced by foresight and defensive tactics.

A second threat to a touch ranger's well-being that they have a great deal of control over is conditions. There are 3 main options for condition removal: Antidote Signet, Plague Touch and Plague Sending. In the hands of a typical touch ranger with no points in the Curses attribute, Plague Touch and Plague Sending will transfer a single condition at a time to an enemy or cluster of enemies at the cost of little energy and perhaps some health. Antidote Signet is the simplest method to cure conditions quickly and for free, simply removing them.

Blood Ritual is the main beneficial skill, boosting the energy regeneration of another ally. To get around the forbidden self-targeting, a pair of rangers can boost each other and double their energy regeneration.

Throw Dirt will blind any foe, including those attacking allies the ranger might want to defend.

Necrosis is a ranged damage skill that simply requires a feeder skill such as Barbed Signet to provide a condition or hex. Because of the high damage and short recharge, it may be worth using instead of a second Vampiric Touch.

Signet of Corruption recovers energy for the ranger when used in combination with area effect skills such as Barbed Signet or Life Transfer. Hitting a cluster of enemies every time is required to make this skill truly worth while, but doing so makes energy from spells like Oppressive Gaze easy to recover.

Unless somehow fighting at range with spells and degen, a touch ranger needs to be in melee range to touch his target, and this can be prevented if the target is able to keep their distance either through kiting or the use of snares. To counter kiting the ranger can use speed boosts such as Dodge or Escape to catch the target, but to counter snares depends on the type being used. The less dangerous form is the cripple condition, which is easy to remedy with Antidote Signet or a condition transfer.

The most dangerous form of snare the ranger faces are hexes, which the ranger is unable to remove. Snare hexes are carried by Elementalists, Mesmers, Ritualists and Assassins. The best a touch ranger can do against hex snares is play defensively, use their self healing, wait for the hex to expire, or possibly try to interrupt and disable a hex snare with Distracting Shot if they have it. Alternatively if there are support characters with hex removal, they might be able to help. Snare hexes are a very common threat in PvP to all characters, and the vulnerability is not unique to touch rangers.

Diversion is a threat common to all characters that spam skills, and the counter is to be alert and simply wait for the hex to expire naturally.

Touch rangers are heavily reliant on energy and its efficient use, so another devastating counter they face is having their energy depleted by Mesmers and Necromancers. Mesmers can steal and burn energy with a wide variety of Domination and Inspiration skills. Necromancers can inhibit energy regeneration with Malaise and Wither, deplete energy with Depravity, or negate the effect of a ranger's Expertise with Atrophy and Wail of Doom. To survive, the ranger has a very inexpensive self-heal in Blood Renewal, an inexpensive stance in the form of Escape, energy recovery in the form of Offering of Blood and a variety of energy-free signets.

Raw healing is also able to counter the touch ranger. Although the damage from life stealing, shadow magic and degen is reliable, it is easily healed by a monk or ritualist with nothing else to do.